Friday, February 03, 2012

Ketamine, Special K, and Depression

I just wrote a post over on Clinical Psychiatry News about the experimental use of ketamine (aka, rave drug "Special K") for instant relief of depression and suicidal ideation.

Please go over there to read it (link above), and feel free to comment there (sorry, registration is required but it's free) or here. I'd like to hear about providers who have used ketamine for their patients and from people who themselves have used it for depression.


Edit: find a list of clinical trials using ketamine for depression on clinicaltrials.gov.

14 comments:

Sarebear said...

Maybe there's hope for me, yet.

Still, if my last psychiatrist would not prescribe Xanax/was uncomfortable with THAT med, I'd make a guess that she'd not touch ketamine with a ten foot pole.

I might ask about it after I develope a rapport ( I hope) with my next psychiatrist, not open out of the gate with it cause, well, I'd rather they know me a little first before I bring up controversial meds like this. But I go in and out of suicidal ideation so often, and I keep coming up with new and varied ways to off myself, that I'd hope a psychiatrist would explore every option; what does the study with bipolar people say about chances ketamine would activate mania, like most or all other anti-depressents can do?

And when you say hallucinations are a side effect, is it alot of hallucinations or just a few? I don't drive, so I could consider this even with that side effect, if the hallucinations weren't frequent and/or bad.

Anonymous said...

Sarebear,
Even if you do not drive, you definitely do not want hallucinations as a side effect. I understand your struggle but do not settle for hallucinations.
Source: experience

Anonymous said...

are these potential hallucinations ongoing for an extended length of time? or are these potential hallucinations something that if they happened would be no more than a few hours (like a bad trip)? Regarding any potential unwelcome side effects...how long does it take a dose of ketamine and it's side effects to clear your system in case it doesn't agree with you? I mean, is it a matter of having a few really bad hours but then it passes? If so, might be worth a try. If potential side effects were going to be longer lasting, then maybe not. Still, very interesting information.

Sunny CA said...

I found your article interesting. As a non-clinician I was left pondering what the difference might be between hallucination and psychosis. That seems a pretty dubious trade-off to me (depression traded for hallucination). It seems some non-drug-company studies need to be done on this to find out what percentage of people have hallucination as a side effect.

Anonymous said...

I would assume that, because Special K is club drug, that the hallucinations are not only temporary, but mostly fun,lol, unlike psychosis , which is mostly not fun. Also the dose for depression is 1/10th what people use to get high. I've got treatment resistant depression and I doubt I'm going to survive it if I don't find a cure. I've tried almost all the antidepressants and their adjuncts and also Transcranial Magnetic Stimulation. I am now entering a clinical trial for Magnetic Seizure Therapy. If that doesn't work I'll try Ketamine. The NIMH in Bethesda Maryland told me they would pay all my expenses to come and participate in their trial. Maybe I'll come visit the Shrink Rappers after I get my hit of Ketamine, lol. If Ketamine doesn't work I might try Deep Brain Stimulation which is an operation that implants a stimulator directly into the brain. They are doing that in Toronto where I live.

dogdoc said...

As a veterinarian battling debilitating bipolar depression with ideations just as menacing as Sarebear describes I am now battling the desire to take some of my own Ketamine! I know it is illegal but super safe! I've never given myself an IV injection or done illegal drugs but am sorely tempted now! All day I've sifted through the studies, listened to radio and TV doc commentries and I think we major depressives may be going in for a quick shot instead of a med check. And then I'll have to worry about my depressed friends nagging me for a new kind of dog fix! After 20years of small animal practice I am SO comfortable with Ketamine that I know this is going to be a personal dilemma!

Sideways Shrink said...

dogdoc
As a shrink who goes by the moniker "sidewaysshrink" for a reason, If you are new to this blog I want you to know that I have been candid about sharing my own experiences with being a patient--I have had a terrible time finding medications that work. I have also been candid on this blog about my other personal issues. I say all this just to preface this heartfelt advice: please find someone else to give you ketamine instead of experimenting with it yourself. I am not saying this as an uptight, rule based person, but as someone who knows that treating yourself, especially with a controlled substance, is messy business. The results can be hard to assess. You can hurt yourself and you can put your license at risk if something goes wrong.

Roy said...

Sarebear: I think the concerns about prescribing xanax are different than the use of ketamine, which wouldn't be a daily drug where you'd give a large supply and be concerned about addiction and withdrawal. By no means is ketamine mainstream or even 2nd, 3rd, or 4th in line. The research, using a single 14-35mg i.v. dose for a 70kg person, is that there may be some hallucinations or perceptual disturbance 1-2 hours after giving it, but we're not talking days later.

Roy said...

Here is a list of ketamine trials from clinicaltrials.gov

dogdoc: "ditto" what sidewaysshrink said. This is not worth the risks of treating yourself. Suggest starting with research psychiatrists closest to you.

anon w/TMS: sorry to hear of your suffering and struggles to find effective treatment.

sunnyca: hallucinations is to psychosis what poodles are to dogs. They are a type of symptom one gets from psychosis. Other symptom types include paranoia, referential ideation, and disorganized thoughts. I wouldn't classify all hallucinations as "fun". Many a bad LSD trip result in bad experiences and outcomes.

The 2010 Diaz-Granados article states "Furthermore, no serious adverse events occurred during the study. The adverse effects noted were comparable to those that occurred in our previous study, where mild perceptual disturbances were observed in most patients only in the first hour after infusion."

Solo's Ma said...

Can you explain the graphic to me? I'm a psych social worker trying to put together a presentation for other psych social workers about the use of NMDA Antagonists in Bipolar and Depression. I've read some articles, but I want to explain the biochemistry better. Thanks.

Shane Ellis said...

I dont CARE about side effects. Regular anti depressants take weeks, or MONTHS to kick in. When I feel like eating a gun, I cant wait weeks for it to go away. I need relief NOW. Antidepressants take away ALL my ambition, make me feel numb, I cant think, uncoordinated, and lazy. I take Norco once a day for a fused left ankle and lots of pain associated with it. the Norco, as bad as it sounds, does take "the blues" away. I feel energetic, motivated, and coherent. I'll take some hallucinations over the blah of antidepressants.

Anonymous said...

I am a physician, with 14 years of drug resistant depression. I have been on every class. best results from wellbutrin, but now it is failing me badly. I am looking for a psychiatrist willing to give me a try on ketamine. anybody know one? my depression is rapidly going downhill. without some breakthrough I won't be going the distance..please help

Steven Daviss MD said...

There are a number of
clinical trials going on for ketamine.

jcat said...

I'm Bipolar 2 which for me means long and resistant depressions that go on for months or years, interspersed with (generally) shorter periods where I function well and get a life, but never tip over into anything near manic.

In one of the really long bad patches in about 2009, pdoc agreed to ketamine trial after I'd read some good stuff online. For me, it was really nothing to get excited about.

There was absolutely no high. There was absolutely no change in mood afterwards. All that happened was that the anaesthetist (only doc who was allowed to administer it), pdoc and me spent two hours in theatre. They chatted about generalities, I lay there waiting to feel something exciting. The most exciting thing that happened was that I held pdoc's hand for about 5 mins, until he asked why I was holding his hand and I realised that I had no idea why I was.

So the only result was that for maybe an hour or so I was very mildly stoned - less so than when the dentist gives me laughing gas. Not quite the result any of us were hoping for :-(